Clinical Neurology research

Aims and Expertise

Our research mainly focuses on multiple sclerosis, an inflammatory demyelinating disease of the central nervous system that affects about 100,000 people in the UK. We have a broad range of expertise in this field, covering disease pathogenesis, pathology, imaging by advanced techniques, experimental disease models, epidemiology, and clinical trials.

Additional areas of research include neuroimmunology and neurodegeneration.

--Cris Constantinescu, Professor of Neurology

Research topics

Our research topics in the field of multiple sclerosis include immunopathogenesis (the immune mechanisms that lead to myelin and axonal damage), the study of the role of infections in the aetiology of the disease and its activation; the role of advanced imaging techniques in the study of tissue damage, in vivo detection of pathology, correlation with neuropathology, and differential diagnosis in the clinic; epidemiology, including the role and mechanisms of smoking in susceptibility and clinical progression of MS; the identification of new therapeutic approaches, including immunomodulation, neuroprotection, and remyelination by pharmacological, biological, and cell-based treatments.

Trials

Group members have participated in pivotal trials that led to the introduction of most drugs currently used in MS, helped establish the principle of some treatments and the basis for combination therapy in multiple sclerosis.

MS Clinical Trials Unit

We have an active, internationally recognised clinical trials unit. We conduct a number of commercial and non-commercial trials, many of which are investigator-led, and collaborate closely with the Comprehensive Clinical Research Network (CLRN) for the National Institute for Health Research (NIHR) portfolio studies.

Outcomes

Clinical service

Our senior academics have clinical honorary contracts within the NHS, and there is fertile ground for bench-to-bedside and bedside-to-bench translational work. We deliver neurological care to a population of more than 3 million people. The MS clinic is possibly the largest in England.

NeuRoi image analysis software

We have developed the NeuRoi image analysis software for processing MRI images. Its application can be found in leading peer-reviewed publications such as Brain andJournal of Magnetic Resonance Imaging.

Publications

Our research has been published in leading journals including Acta Neuropathologica and Brain.

Study on use of stem cells in treatment of multiple sclerosis (MS) - Acta Neuropathologica - October 2012

A study by Dr Bruno Gran and researchers in the US which looked at how stem cells could be used to treat multiple sclerosis (MS) has been published in the leading journal Acta Neuropathologica. The study is part of a long-term collaboration with colleagues at Thomas Jefferson University in Philadelphia, USA.

Multiple sclerosis (MS) is a neurological disease that usually starts in young adult age. Neural stem cells (NSC) have been reported to suppress the development of experimental autoimmune encephalomyelitis (EAE), an animal model of multiple sclerosis (MS). Such NSC can be injected intravenously in mice with central nervous system inflammation and can reach the brain, reducing its inflammation. However, they are relatively slow in their migration to the brain.

Using an experimental model of the disease in the study, the scientists looked at how to make such NSC more efficient in entering the inflamed brain and suppressing inflammation. To this aim, molecular biology techniques were used to make these cells express high levels of a receptor (named CCR5) for molecules (chemokines) that attract immune cells to the brain.

The result was that after intravenous injections, such engineered NSC rapidly brain inflammatory foci in larger numbers, and more effectively suppressed CNS inflammatory infiltration, damage to nerve myelin, and the degree of paralysis in mice affected by EAE, in comparison with NSC that had not been ‘transduced’ with CCR5. Mice that received CCR5-expressing NSC also showed a significant improvement in the degree or nervous system repair.

Another important aspect of this study was that NSC used in this study were obtained from the bone marrow after differentiation in vitro, without the need for invasive procedures in the central nervous system. These properties make them a good candidate for use in human therapy for MS.